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A factor analytic study in bipolar depression, and response to lamotrigine

Published online by Cambridge University Press:  24 June 2014

P Mitchell,
G Malhi and
D Hadzi-Pavlovic
P Mitchell
Affiliation:
School of Psychiatry, University of New South WalesThe Black Dog Institute
G Malhi
Affiliation:
The Black Dog InstituteAcademic Discipline of Psychological Medicine, Northern Clinical School, The University of SydneyPrince of Wales Medical Research Institute, Sydney, Australia
D Hadzi-Pavlovic
Affiliation:
School of Psychiatry, University of New South Wales
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Abstract

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Information

Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006, pp. 262 - 263
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

This study aimed to identify and compare factors of a 31-item version of the HDRS (HDRS-31) in large samples of patients with bipolar and unipolar depression, then examine for any responsiveness of such factors to the anticonvulsant agent lamotrigine in the bipolar depressed sample.

Methods:

This multivariate analytical study was performed on two large depressed samples (one bipolar and the other unipolar) that had been recruited for separate double-blind placebo-controlled trials of la-motrigine. Both studies had very similar designs and assessment tools, the major measures being the MADRS and HDRS-31. To identify the constructs underlying the scale, exploratory factor analyses were applied to the HDRS-31. Treatment responsiveness in the bipolar depressed sample – as indicated by improvement in the total MADRS and HDRS-31, as well as any HDRS factors – was examined using both a mixed-effects analysis and individual time-point t-tests.

Results:

Seven factors of the HDRS-31 were identified: I – ‘depressive cognitions’, II – ‘psychomotor retardation’, III – ‘insomnia’, IV – ‘hypersomnia’, V – ‘appetite and weight change’, VI – ‘anxiety’ and VII – ‘anergia’. A significant therapeutic effect of lamotrigine in bipolar depression was found using the ‘depressive cognitions’ factor (from week 3) and ‘psychomotor retardation’ (from week 4).

Conclusions:

This study has identified seven factors of the HDRS in a large sample of patients with bipolar depression. It suggests that the major effect of lamotrig-ine in bipolar depression is primarily upon central depressive cognitions and psychomotor disturbance.